^(153)Sm-EDTMP对多发性骨转移癌骨痛作用机制的初步探讨  

Study on the Mechanism of^(153)Sm-EDTMP Palliation for Painful Skeletal Metastases

作　　者：程光华[1] 戴云海[1] 陈卫[1] 肖建军[1] 

机构地区：[1]皖南医学院弋矶山医院核医学科,241001

出　　处：《放射免疫学杂志》2004年第3期189-191,共3页Journal of Radioimmanology

基　　金：安徽省教育厅自然科学研究计划项目 ;编号 :2 0 0 2kj318

摘　　要：目的 :探讨153 Sm -EDTMP对多发性骨转移癌患者痛反应与体内疼痛因子的变化的关系。方法 :对5 5例多发性骨转移癌患者153 Sm -EDTMP治疗前与治疗 (1～ 2 )个月及 3个月后血浆内皮素 (ET)、降钙素基因相关肽 (CGRP)、血栓素B2 (TXB2 )与 6酮 -前列腺素F1α(6 -k -PGF1α)含量变化进行了测定。结果 :治疗 3月后 6 9 1% (38/ 5 5 )患者疼痛缓解。TXB2 水平治疗前、治疗 1月～ 2月与治疗 3月后 ,差异均无显著意义 (P均>0 0 5 ) ;6 -k -PGF1α含量治疗 1月～ 2月与治疗前相比显著降低 (P <0 0 1) ,治疗 3月后显著高于治疗前 (P<0 0 1)及治疗 1月～ 2月 (P <0 0 1)。治疗 1月～ 2月血浆ET水平与治疗前相比无显著降低 (P >0 0 5 ) ,治疗 3月后与治疗 1月～ 2月、治疗前相比显著升高 (P均 <0 0 1) ;CGRP含量治疗 1月～ 2月与治疗前相比显著升高 (P <0 0 5 ) ,治疗 3月后较治疗 1月～ 2月显著减低 (P <0 0 1)、与治疗前相比无显著性差异 (P >0 0 5 )。ET/CGRP值治疗 3月后显著高于治疗 1月～ 2月及治疗前 (P均 <0 0 1)。结论 :多发性骨转移癌患者治疗后骨痛反应与疼痛因子 6 -k -PGF1α含量密切相关 ,与体内的ET含量以及ET和CGRP之间的平衡变化有关。Objective Study the mechanism of therapeutic response through measurements of the changes of pain related factors levels in patients treated with 153Sm-EDTMP for painful skeletal metastases. Methods Plasma endothelin (ET)、 calcitonin gene-related peptide (CGRP)、 thromboxane B 2 (TXB 2) and 6-keto-prostaglandin F 1α (6-k-PGF 1α) levels were measured with RIA in 55 patients with painful skeletal metastases prior to and 1-zamonths、 3months after 153Sm-EDTMP treatment. Results 38 patients (69.1%) experienced pain relief 3 months after 153Sm-EDTMP treatment. Laboratory tests showed that 6-k-PGF 1α levels decreased significantly 1～2 months after treatment then increased significantly by 3 months (vs before treatment, both P<0.01). No significant changes of TXB 2 levels were observed. ET levels decreased significantly 1～2 months after treatment (P<0.01) and again increased significantly by 3 months (vs before treatment, both P<0.01). CGRP levels increased significantly 1～2 nonths after treatment (P<0.01). But reduced to prior levels by 3 months (P>0.05). ET/CGRP ratio at 3 months was significantly higher than that at 1～2 months after treatment and prior to treatment both (P<0.01). Conclusion The therapeutic response of 153Sm-EDTMP palliation for painful skeletal metastases may be closely related to the elevation of plasma 6-k-PGF 1α levels and ET/CGRP ratio.

关 键 词：^153SM-EDTMP 多发性骨转移癌 骨痛 作用机制 内皮素 血栓素B2 

分 类 号：R738.1[医药卫生—肿瘤]